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Covid-19 Vaccination Report
Student Vaccination Report
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* Indicates required question
Email
*
Your email
Student Code
*
Your answer
Name
*
Your answer
Roll No.
Your answer
Mobile No.
*
Your answer
Class
*
Choose
UG 1st Semester
UG 2nd Semester
UG 3rd Semester
UG 4th Semester
UG 5th Semester
UG 6th Semester
PG 1st Semester
PG 2nd Semester
PG 3rd Semester
PG 4th Semester
Are you vaccinated?
*
Yes
No
If Yes, Date of 1st Dose
MM
/
DD
/
YYYY
If Completed, Date of 2nd Dose
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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